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General NPI Number Information
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NPI Number | 1821757030
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Entity Type | Individual
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Provider Name | ANSELM A PARLATORE MD
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Gender | Male
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Dates
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Enumeration Date | 12/15/2021
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Last Update Date | 01/05/2022
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Provider Practice Location Address
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Address Line | 20301 BOND RD #150
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City | POULSBO
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State | WA
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Zip | 98370
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Country | US
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Telephone | 360-739-9865
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Fax | 360-881-0810
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Provider Business Mailing Address
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Address Line | 25970 SHOALWATER PL NE
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City | KINGSTON
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State | WA
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Zip | 98346
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Country | US
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Telephone | 360-739-9865
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Fax | 360-881-0810
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 00026485
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License Number State | WA
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